Ignite Creation Date:
2024-05-05 @ 4:35 PM
Last Modification Date:
2024-10-26 @ 9:22 AM
Study NCT ID:
NCT00274118
Status:
COMPLETED
Last Update Posted:
2013-11-01
First Post:
2006-01-09
Brief Title:
DETAIL Study Diabetes Exposed to Telmisartan and Enalapril
Sponsor:
Boehringer Ingelheim
Organization:
Boehringer Ingelheim
Study Overview
Official Title:
DETAIL Diabetics Exposed to Telmisartan And enalapIL A Randomised Double-blind Parallel-group Comparison of the Renal and Antihypertensive Effects of Telmisartan and Enalapril in Subjects With Mild to Moderate Hypertension and Concurrent Type II Diabetes Mellitus and Diabetic Nephropathy
Status:
COMPLETED
Status Verified Date:
2013-10
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
To compare the renal consequences of two different approaches to blocking the renin angiotensin system in subjects with hypertension and concurrent Type II diabetes mellitus and diabetic nephropathy
Detailed Description:
The aims of this study were to compare the renal consequences of two different approaches to blocking the activity of the renin angiotensin system - Angiotensin II antagonism with telmisartan and ACE inhibition with enalapril - in patients with hypertension and concurrent type II diabetes mellitus and diabetic nephropathy
The study was designed to investigate albumin excretion rates in the short term and in the longer term to assess the outcome with respect to maintenance of renal function GFR and incidence of clinical endpoints
Study Hypothesis
Association of Hypertension and Diabetes Essential hypertension accounts for the majority of hypertension in people with diabetes particularly in those with type II diabetes who constitute more than 90 of those with a dual diagnosis of diabetes and hypertension
Both diabetes and hypertension each confer increased cardiovascular risk and patients with both conditions have more atherogenic risk factors
Albumin Excretion as a Therapeutic Marker Microalbuminuria is an early and reliable predictor of diabetic nephropathy in both type I - insulin dependent diabetes mellitus IDDM and type II - non insulin dependent diabetes mellitus NIDDM patients nephropathy being characterised by hypertension and an inevitable decline in renal function
Furthermore diabetic nephropathy is the single most important cause of end stage renal failure ESRF in the western world and over recent years the incidence of ESRF in patients with type II diabetes has dramatically increased
In addition to predicting nephropathy in type II diabetes microalbuminuria also predicts mortality the major causes of death being related to cardiovascular disease
Comparisons
Selection of an ACE Inhibitor as the Comparative Agent Findings in preclinical studies of animals with diabetes mellitus suggest that ACE inhibitors reduce glomerular damage by one or more mechanisms independent of their antihypertensive effects Glomerular efferent arteriolar tone is increased in diabetic animals and as a result there is an increase in transcapillary hydraulic pressure These alterations may decrease the functional integrity of the glomerular capillary wall In rats with diabetes the long term administration of an ACE inhibitor diminishes the functional and morphologic evidence of glomerular injury and decreases glomerular transcapillary pressure Removal of the tonic constrictor effect of angiotensin II on efferent arterioles would be expected to lower glomerular intracapillary pressure while preserving renal plasma flow
Angiotensin II antagonists appear to be as effective as ACE inhibitors in delaying the progression of renal injury in animal models of diabetes
The study was designed to investigate albumin excretion rates in the short term and in the longer term to assess the outcome with respect to maintenance of renal function GFR and incidence of clinical endpoints
Study Hypothesis
Association of Hypertension and Diabetes Essential hypertension accounts for the majority of hypertension in people with diabetes particularly in those with type II diabetes who constitute more than 90 of those with a dual diagnosis of diabetes and hypertension
Both diabetes and hypertension each confer increased cardiovascular risk and patients with both conditions have more atherogenic risk factors
Albumin Excretion as a Therapeutic Marker Microalbuminuria is an early and reliable predictor of diabetic nephropathy in both type I - insulin dependent diabetes mellitus IDDM and type II - non insulin dependent diabetes mellitus NIDDM patients nephropathy being characterised by hypertension and an inevitable decline in renal function
Furthermore diabetic nephropathy is the single most important cause of end stage renal failure ESRF in the western world and over recent years the incidence of ESRF in patients with type II diabetes has dramatically increased
In addition to predicting nephropathy in type II diabetes microalbuminuria also predicts mortality the major causes of death being related to cardiovascular disease
Comparisons
Selection of an ACE Inhibitor as the Comparative Agent Findings in preclinical studies of animals with diabetes mellitus suggest that ACE inhibitors reduce glomerular damage by one or more mechanisms independent of their antihypertensive effects Glomerular efferent arteriolar tone is increased in diabetic animals and as a result there is an increase in transcapillary hydraulic pressure These alterations may decrease the functional integrity of the glomerular capillary wall In rats with diabetes the long term administration of an ACE inhibitor diminishes the functional and morphologic evidence of glomerular injury and decreases glomerular transcapillary pressure Removal of the tonic constrictor effect of angiotensin II on efferent arterioles would be expected to lower glomerular intracapillary pressure while preserving renal plasma flow
Angiotensin II antagonists appear to be as effective as ACE inhibitors in delaying the progression of renal injury in animal models of diabetes
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None